Communication with someone with dementia is often full of challenges, misunderstandings, and emotionally difficult situations. It is not always easy to know what to say, how to react, or how to help without hurting the other person’s feelings. In this article, we will show you through practical examples how to address a loved one with dementia in various situations.
We will discuss why praise and positive reinforcement are crucial, how to communicate not just with words but also with body language, and how your own mood affects them. Additionally, you will find specific examples of what to say and how to behave when they are angry, repetitive, or perhaps do not recognize you.
The goal is for you to be able to handle these everyday situations with more confidence and calm.
Living in their own world
Communicating with someone with dementia is one of the most difficult tasks in daily care. It often happens that they no longer understand exactly what is being said to them, or they themselves cannot express what they feel or think. Many people with dementia seem to live in their own internal world where words can no longer reach them. This is extremely taxing for family members as well, as familiar conversations are replaced by misunderstandings, repetitions, and emotional tension.
Common communication situations
Let’s look at some common communication situations and how it’s best to react.
1. When they are angry, restless, or irritated
At these times, the most important thing is not to try to convince them they are wrong or to scold them. Arguing only increases the tension. Instead, it is better to soothe them and distract their attention. It often helps to simply agree with them, even if they are not right.
For example:
❌ “Don’t be so nervous!”
✅ “I understand this is upsetting you right now. Let’s see what we can do.”
Or:
❌ “Nothing happened, calm down!”
✅ “I see this is difficult right now. Let’s sit down for a bit, I’ll bring some tea.”
Empathy and distraction are much more effective than logical reasoning!
2. When they do not recognize you
This is one of the most painful situations. However, it is important to know that this is not intentional. In these cases, do not hold it against them and do not ask “why don’t you remember me?” type questions. Instead, help them.
For example:
❌ “Don’t you recognize me?”
✅ “Hi, it’s me, Anna, your daughter.”
If they mistake you for someone else:
❌ “No, I’m not that person!”
✅ In this case, the best thing is to say nothing and not correct them.
The key is acceptance and agreement. It is better than upsetting your loved one or generating an argument.
3. When they repeat things constantly
Repetitive questions are extremely exhausting. Over time, one becomes impatient, which is completely understandable. Yet, it is important to try to stay calm.
A useful solution can be writing the answer on a piece of paper and putting it in a clearly visible place. Additionally, it can help to steer the conversation in a different direction.
For example:
❌ “I’ve already told you ten times!”
✅ “Yes, we’ve talked about it. Look, I wrote it down for you here.”
Patience is key, even if it is often draining.
Praise
In communication with someone with dementia, praise and positive reinforcement play an outstandingly important role. As the illness progresses, they experience more and more uncertainty: they don’t understand the world around them, they make mistakes, they forget things. In these moments, criticism or impatience can easily further destroy their self-confidence.
In contrast, praise:
- increases self-confidence
- strengthens self-esteem
- provides a sense of security
- motivates cooperation
- reduces anxiety
It is worth much more than a warning or a “scolding.”
Examples of positive reinforcement:
- “You handled that very skillfully.”
- “Thank you for helping me.”
- “See, that went very well just now.”
- “I’m so glad we did this together.”
- “That was really kind of you.”
It’s not just WHAT you say, but HOW you say it
Someone with dementia often does not understand the words, but rather the mood, the tone, and the body language.
Pay attention to these:
- speak slowly, in a calm voice
- maintain eye contact
- a gentle touch (holding hands, touching the shoulder) can provide security
- avoid sudden movements
- speak kindly
Very important: your loved one with dementia picks up on your mood.
If you are nervous, tense, or impatient, they will be too.
If you are calm and kind, their condition may also improve.
Specific situations – how to do it in practice
1. If they are angry
What to say:
“I see something is wrong, tell me what’s bothering you? I’m here, I’ll help.”
How to say it:
- in a quiet, slow voice
- with a calm facial expression
- kindly
Body language:
- eye contact
- open posture (palms visible, turned towards them, uncrossed limbs, upright but not tense posture)
Praise:
“It’s very good that you’re telling me what’s bothering you.”
2. If they repeat things constantly
What to say:
“Yes, you’ve asked that already, so I wrote it down for you.”
How to say it:
- patiently, in a similar tone every time
- without sighing or being irritated
Body language:
- calm movements
- showing the paper, pointing to it
Praise:
“It’s very good that you asked, so you can be sure.”
3. If they do not recognize you
What to say:
“Hi, it’s me, Peter, your son. I came so we could spend some time together.”
How to say it:
- kindly, with a smile
Body language:
- friendly facial expression
- slow approach
- eye contact
Praise:
“I’m very happy that we are chatting.”
More about communication: NON-VERBAL COMMUNICATION IN DEMENTIA CARE – Dementia in practice
How to Communicate with Someone Living with Dementia – Dementia in practice
The most important thing is to focus not on the “correct answer,” but on the feeling
The most important thing is to focus not on the “correct answer,” but on the feeling. In dementia, it is often no longer the words, but the connection that truly matters. Let’s think about how hard it is to connect with them, as dementia often builds an invisible wall between us, causing us to live in two separate worlds. They live in theirs, and we live in reality. Therefore, it is important that when we have the opportunity to connect and talk with them, we do it in a way that is a positive conversation, situation, and experience for both them and us. Because when they are no longer with us, we will think back on these “well-handled situations” with a good feeling; it will be a fond memory, filled with heart-warming emotions.
Small daily victories lead to long-term peace. This post is part of our Daily Care & Safety-Practical Guides for Dementia Caregivers – Dementia in practiceresource center, where we share creative techniques for hygiene, medication, and creating a secure home environment. Discover more practical guides to make your daily routine smoother.
Important Disclaimer
The information and advice presented on this website and in this article are for informational purposes only. They do not constitute a medical diagnosis or individual therapeutic recommendations. The operator/author of the website assumes no liability for any direct or indirect damages, health issues, or misunderstandings resulting from the use of this information. Everyone applies the described methods at their own risk. Please consult your physician before making any lifestyle changes or applying any complementary therapies.
About the Author
Suzanne Sandwiese – Dementia Caregiver, Mental Health Assistant
I have more than 12 years of practical experience in caring for elderly people and patients living with dementia. My goal is to translate knowledge about dementia into understandable, practical advice that can be applied in daily life, thereby helping families live together with the disease. As the author of several professional books and the founder of a popular Facebook page, my mission is to provide clear and, above all, usable guidance to all those who care for loved ones living with dementia.